Immunohistological study with peroxidase-antiperoxidase staining in a case of generalized prepubertal periodontitis

A case of prepubertal periodontitis was observed and examined immunohistologically with peroxidase-antiperoxidase staining. The patient was an 11-year and 7-month-old Japanese girl, well-developed and well-nourished. Her parents were first cousins. Her chief complaint was the loosening and loss of the permanent teeth. There was a similar history of primary dentition. Her remaining permanent teeth were loosened with severe alveolar bone loss, but calculus deposit was minimal. Significantly, there was no palmar-plantar hyperkeratosis. General examination showed normal data except for the increase of the immunoglobulin concentrations. In neutrophil function tests chemotaxis was depressed, although phagocytosis, random migration and superoxide production were within normal limits. Histologically, neutrophils were seen in the gingival tissue and other findings were also similar to those of adult periodontitis. In immunohistological examination, IgG-bearing cells which mostly consisted of plasma cells predominated in the lesion. Considering the past history, the immunodeficiency and the absence of palmar-plantar hyperkeratosis, the case was diagnosed as prepubertal periodontitis.